Project: Ghana Emergency Medicine Collaborative Document Title: Introduction to Nursing Research Author(s): Sue Anne Bell (University of Michigan), RN 2012 License: Unless otherwise noted, this material is made available under the terms of the Creative Commons Attribution Share Alike-3.0 License: http://creativecommons.org/licenses/by-sa/3.0/

We have reviewed this material in accordance with U.S. Copyright Law and have tried to maximize your ability to use, share, and adapt it. These lectures have been modified in the process of making a publicly shareable version. The citation key on the following slide provides information about how you may share and adapt this material. Copyright holders of content included in this material should contact open.michigan@umich.edu with any questions, corrections, or clarification regarding the use of content. For more information about how to cite these materials visit http://open.umich.edu/privacy-and-terms-use. Any medical information in this material is intended to inform and educate and is not a tool for self-diagnosis or a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional. Please speak to your physician if you have questions about your medical condition. Viewer discretion is advised: Some medical content is graphic and may not be suitable for all viewers.

1

Attribution Key

for more information see: http://open.umich.edu/wiki/AttributionPolicy

Use + Share + Adapt

Make Your Own Assessment

Creative Commons – Attribution License

Creative Commons – Attribution Share Alike License

Creative Commons – Attribution Noncommercial License

Creative Commons – Attribution Noncommercial Share Alike License

GNU – Free Documentation License

Creative Commons – Zero Waiver

Public Domain – Ineligible: Works that are ineligible for copyright protection in the U.S. (17 USC § 102(b)) *laws in your jurisdiction may differ

Public Domain – Expired: Works that are no longer protected due to an expired copyright term.

Public Domain – Government: Works that are produced by the U.S. Government. (17 USC § 105)

Public Domain – Self Dedicated: Works that a copyright holder has dedicated to the public domain.

Fair Use: Use of works that is determined to be Fair consistent with the U.S. Copyright Act. (17 USC § 107) *laws in your jurisdiction may differ Our determination DOES NOT mean that all uses of this 3rd-party content are Fair Uses and we DO NOT guarantee that your use of the content is Fair.

To use this content you should do your own independent analysis to determine whether or not your use will be Fair.

{ Content the copyright holder, author, or law permits you to use, share and adapt. }

{ Content Open.Michigan believes can be used, shared, and adapted because it is ineligible for copyright. }

{ Content Open.Michigan has used under a Fair Use determination. }

2

What would you do?

¨ A Philanthropist puts a notice on the bulletin board in the A&E. She wrote that she is willing to fund a GHC200,000 nursing study in honor of her mother who was an A&E nurse.

¨ She is asking for suggestions. What study would you suggest?

3

Importance of Nursing Research

¨ Nursing research empowers every nurse’s clinical practice.

¨ Nurses can ask questions aimed at gaining new knowledge to improve patient care, the nursing profession and health care overall.

¨ Research-based (evidence based) practice = integrating research findings into clinical decision making

4

Importance of Nursing Research

¨ Accountability for care-related decisions

¨ Research expands nursing practice

¨ Reinforce the identity of nursing as a

profession – knowing/ understanding our

patients and the health care experience

5

How Does this Affect Our Work in the A&E?

¨  How can nurses improve their credibility in the health sciences? ¤ By showing credible findings that demonstrate their impact on

health.

¨  Do you know certain aspects of patient care in the A&E that aren’t working? Or certain ways that work better than others? ¤ Research on these topics can help to change problems or

reinforce positive solutions.

6

History of Nursing Research

¨  Began with Nightingale and the Crimean War- mid

1800s

¨  Early 1900s – problems in nursing: education,

staffing issues

¨  1960s Practice oriented research; first nursing

research journals

¨  1983 - ANA Center for Research for

Nursing Biswajyotim, OCAL 7

Research- fun and exciting?

¨ “The essence of all research originates in curiosity - a desire to find out how and why things happen”

¨ How can…?

¨ Why is…?

¨ What is the best way to…?

¨ What causes…?

¨ What are the effects of…?

I wonder... 8

Scientific Inquiry

¨ Observable, verifiable data is collected in

order to:

¤ Describe

¤ Explain

¤ Predict events

9

Scientific Method

¤ Select/define a problem

¤ Formulate a research question/

hypothesis

¤ Collect data

¤ Analyze data

¤ Report results 10

Scientific Method

¤ Objectivity – distance research from

personal beliefs, values, attitudes Why???

¤ Empirical Data – documenting objective data through direct observation = reality

11

Research Questions

¨ Cannot be answered by Yes or No.

¨ Should ask: ¤ What happens when…..? ¤ What is going on here? ¤ How does this happen? ¤ Why does on thing work better than another?

12

Nursing Research

¨ Application of scientific method to areas of interest to nursing

¨ Primarily involves studying people – People do not behave consistently as do objects/chemicals in a laboratory!

This poses special challenges!

13

Evidence-Based Nursing Practice

¨  EBNP is the process by which nurses make clinical decisions based on the best available research evidence, their clinical practice and patient preferences, in the context of available resources.

¨  Practice based on evidence from nursing research is an

approach that enables clinicians to provide the highest quality of care in meeting the multifaceted needs of patients and families.

Budin, 2008

14

15

The Research Idea: Where does it come from?

¨ Professional experience ¨ Burning questions ¤ Yours ¤ Others

¨ Literature ¨ Professional meetings ¨ Discussions

16

Research Topics

¨ Observations ¨ Behaviors ¨ Concepts ¨ Theories ¨ Testing of assessment and intervention

strategies

17

A Research Question Must Identify

1.  The variables under study 2.  The population being studied 3.  The testability of the question

18

Criteria for developing a good research question: FINER

¨ Feasibility

¨  Interesting

¨ Novel

¨ Ethical

¨ Relevant

n  Cummings et al. 2001

FINER

Feasible ¤ Subjects ¤ Resources ¤ Manageable ¤ Data Available Interesting Novel

q New idea, untested idea Ethical

q Social or Scientific Value q Safe

Relevant q Advance scientific knowledge q Influence clinical practice

19

¨  Qualitative ¨  Quantitative ¨  Descriptive ¨  Correlational ¨  Quasi-Experimental ¨  True Experimental – Randomized Controlled Trial (RCT) ¨  Meta-Analyses and Systematic Reviews

Research Design: the basics

20

Quantitative Research

¨ Formal, objective, systematic process using ¤  measurement ¤  hypothesis testing ¤  data analysis

¨ Traditional approaches such as experiments, questionnaires, surveys

jean_victor_balin, OCAL 21

Quantitative Process

1.  Identify the research problem. 2.  Review related literature. 3.  Frame the problem conceptually. 4.  Formulate hypotheses. 5.  Select a design. 6.  Identify population, sampling plan. 7.  Select and test methods to measure variables.

22

Quantitative Process (Continued)

9.  Protect human rights. 10.  Review and finalize the research plan. 10.  Collect the data. 11.  Analyze the data. 12.  Interpret the findings. 13.  Communicate the findings. 14.  Participate in the process of disseminating

the findings.

23

Qualitative Research

¨ Evaluate subjective life experiences and give

meaning to them

¨ Focuses on understanding phenomena from an

individual’s perspective

¨ Approaches: observation, in-depth interviews, case

studies, narrative analyses

24

Qualitative Process

1.  Identify a research problem. 2.  Do a literature review. 3.  Select and gain entrée into research

sites. 4.  Utilize a design that emerges as data is

collected. May be ethnographic, phenomenological, grounded theory, historical.

25

Qualitative Process (Continued)

5.  Address ethical issues. 6.  Collect the data. 7.  Analyze the data. 8.  Interpret the findings. 9.  Communicate the findings. 10.  Participate in the process of

disseminating the findings.

26

The Research Language - Some Terminology

¨ Variable ¨ Data ¨ Rigor ¨ Control ¨ Sampling ¨ Setting

juliobahar, OCAL 27

Concept of a Variable

¨ Measurable characteristic that varies among subjects

¨ Research is conducted because this variance occurs!

¨ Types: ¤ Independent – presumed cause

n Example: Salt intake

¤ Dependent – presumed effect n Example: Blood pressure reading

28

Variables

n  Have 2 or more properties or qualities ¨ Age, sex, weight, height

n  Is one variable related to another? ¨ “ Is X related to Y? What is the effect of X on Y?” etc.

29

Data

¨ Pieces of information obtained in a study

¨ Are the actual “values” of the study variables

¤ Quantitative - numeric values

¤ Qualitative - narrative descriptions

30

Concept of RIGOR

¨ Striving for excellence in research. Involves:

¤ Discipline

¤ Adherence to detail

¤ Strict accuracy!

¤ Uses precise measurement tools

sarxos, OCAL 31

Concept of CONTROL

¨  Using “rules” to decrease error and increase probability that study findings are an accurate reflection of reality

¨  Ensure results that reflect true relationship among variables

¨  Reduction of the influence of unwanted “extraneous” variables

¨  Example: A control group of test subjects left untreated or unexposed to some procedure in order to provide a standard of comparison to the experimental group.

32

Concept of SAMPLING

¨ Who/what do you want to study?

¨ Choosing subjects who are “representative” of the study population

¨ Random & Non-Random Sampling- when to

use?

josephluis, OCAL 33

Concept of SETTING

¨ Location of the study - can affect results ¨ Natural Setting: Uncontrolled, real life situation ¨ Partially Controlled: Manipulated or modified in

some way ¨ Highly Controlled: Artificial environment for sole

purpose of doing research. Decreases effects of outside influences.

34

Some Myths About Research

¨  The purpose of research is to “prove” or “confirm” a theory.

¨ Research findings are presented as complete and conclusive answers.

¨ There is a hierarchy of research methodology that places true “experimental” research at the top.

35

Intro to the Research Process

¨  Involves decision making ¤ What methods will help to answer a research

question/test a hypothesis?

¨  Is flexible - multiple possibilities, each with its own strengths/weaknesses

¨  Is a circular process

JoBrad, OCAL 36

The Research Process

¨ What do I want to know?

¨ Does anyone else know anything about this?

¨  I’ll make an educated guess about what I think the

answer to my question will be.

¨ Here’s what I’m going to do to try to answer my

question.

37

The Research Process

¨  I’ll try to make sense out of all this info I’ve

collected.

¨ What did I find? Was my hunch supported?

¨ What do I want to know now???

38

Major Phases in the Research Process

¨ 1. Selecting and defining the problem in need of investigation

¨ 2. Selecting a research design

¨ 3. Collecting data

¨ 4. Analyzing data

¨ 5. Utilizing the Findings 39

Background

¨  Selecting and defining the problem (area of research)

¨  Identify a question or area where knowledge can be advanced

¨  Review related literature for rationale to do study

¨  Identify a theoretical framework to guide the study.

¨  Propose a research question and/or hypothesis 40

Design, Variables and Sample

¨  Choose study or research design ¨  Identify a Study Population ¨ Design Sampling Plan ¨ Define how will variables be measured

¤ Setting ¤ How data will be collected - tools

¨ Pilot Study - Revisions

41

Gathering the Data

¨  Data Collection - according to pre-established plan (implements the plans designed in Phase I & II) ¤  recruiting ¤ obtaining consent ¤  training staff ¤  collecting data

¨  Organization of the data ¤ How do you analyze the data? ¤  (must be appropriate form)

¨  May be the longest phase of the research process

Anonymous, OCAL 42

Analyze and Interpret

¨  Data Analysis

¨  Interpret findings

¤ Draw conclusions

¤ Hypothesis is supported or rejected (chap 10)

¤ How best to utilize findings?

¤ New question formulated? (can lead to new questions that can stimulate further study)

43

Dissemination

¨ Disseminate findings - Share findings with colleagues

¤ May report findings in journal articles, oral

presentations, poster presentations

¨ Utilize findings - use in nursing practice

44

Types of Research: Basic Vs. Applied

¨ Basic or “Pure” Research:

¤ Pursuit of knowledge or finding truth

¤ Generates, refines or tests theory

¤ Often uses laboratory setting

¤ Findings may not be directly useful in practice ¤ May be used later in development of

treatment/drug/theory

johnny_automatic, OCAL 45

Basic Vs. Applied

¨ Applied or “Practical” Research ¤ Knowledge intended to directly influence clinical

practice ¤ Conducted in actual practice conditions ¤ Solve problems, make decisions, predict/control

outcomes ¤ Evaluate interventions ¤ Test/validate theories ¤ Evaluate “Basic” research knowledge for usefulness

46

Experimental vs. non-experimental

¨  Experimental: Researcher manipulates or controls variable(s) and observes effect in other variable(s)

¨  Evaluates cause and effect relationship

¨  Ex: Does a pre-op intervention program to ↑ self efficacy affect self care measures post-op?

¨  Non-experimental: Describes or looks at relationships(s) or correlation between variables.

¨  Variables are not manipulated by the researcher

¨  Ex: Correlation between HRT use and breast CA

47

Descriptive Research

¨  Uses questionnaires, surveys, interviews or observations to collect data

48

Correlation Research

¨  Relationships between and among variables ¨  Collection of data on at least 2 variables for the same

group of individuals ¨  Calculator-the correlation between the measurer ¨  Highest number of research studies in nursing are

classified as description correlation design

49

Time dimension: Retrospective vs. Prospective

¨  Retrospective: Examines data already collected in the past

¨  Ex: Review of medical records to examine previous history in of cholesterol levels in s/p MI patients

¨  Prospective: examines data being collected in the present

¨  Ex: Study describing social support and coping mechanisms of women with ovarian CA

nicubunu, OCAL 50

Time Dimension: Cross-Sectional vs. Longitudinal

¨ Cross-sectional: Collects data at one point in time

¨ What exists today?

¨ Longitudinal: Studies examines variables of interest over a period of time

¨ Advantages –ability to collect data on the same individual over time

51